LDL cholesterol is a better indicator of cardiovascular risk than total cholesterol.
The American Heart Association also made lenient definitions of the risk of various
levels of LDL-C. The AHA considered an LDL-C level of
100 to 129 mg/dl to be “near or above optimal.” If the mean level of LDL cholesterol for American adults age 20 and older is 112.1 mg/dl, then a high proportion of the American public is, according to the AHA, “near or above optimal” and not at
the “borderline high” level.
Is there is a level of LDL-C at which there are essentially no adverse cardiovascular
events related to atherosclerosis? One estimate is that the threshold for progression
of atherosclerosis is approximately 70 mg/dl. Another estimate is that the LDL-C
level at which cardiovascular event rates may approach zero is about 60 mg/dl for
primary prevention (no previous clinical coronary disease), and 30 mg/dl for secondary
prevention (previous clinical coronary disease).
The average level of LDL-C for American adults age 20 and older is 112.1 mg/dl.
In populations of hunter-gatherers, LDL-C is estimated to be 50-75 mg/dl, and that
of newborn babies is 30-70 mg/dl. Atherosclerotic vascular disease almost never
occurs in people with the inherited disorder (familial hypobetalipoproteinemia) that
causes very low LDL-C levels, 30-40 mg/dl. They can expect a lifespan that is 15
years longer than average.
A large 2009 study of 136,905 hospital patients with heart attacks found that 72.1%
of those admitted had LDL-C levels lower than 130 mg/dl, a level that the AHA
would call “near or above optimal.” And the same study found that half of the patients
with a history of heart disease had LDL-C levels lower than 100 mg/dl, a level
the AHA would consider “optimal.” Even an LDL-C below 70mg/dl was not fully
protective against heart attack, 17.6% of patients had LDL-C below this level.
For optimal heart health, the goal for LDL-C should be 70 mg/dl or lower.
This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.